When doctors stay in their lane
Here is the paper, showing massive overdiagnosis, even following testing. If you don’t wish to click through, here is a nice summary:
summary:
Clinicians widely overestimated chance of disease especially after testingCardiac ischemia after + ECG—EBM 2-11%, median answer 70%
UTI after + urine cx—EBM 0-8.3%, answer 80%
Breast CA after + mammo—EBM 3-9%, answer 50%
Pneumonia after + CXR EBM 46-65%, answer 95%— Dan Morgan (@dr_dmorgan) April 12, 2021
So what’s it like being red-pilled by the median voter theorem?
President Biden will limit the number of refugees allowed into the United States this year to the historically low level set by the Trump administration, reversing an earlier promise to welcome more than 60,000 people fleeing war and persecution into the country.
Here is more from the NYT. I have been stressing for several years now that the Democrats are not going to die on the hill of an ultimately unpopular immigration policy. Here is an earlier Angus, penned before the Afghanistan withdrawal news:
Kids? Still in cages.
Min wage? Still $7.25.
Student debt? Still unforgiven.
Stimmy? 2 trillion from DJT, 2 trillion from JB.
China? Still tariffed.
Gitmo? Still openmedian voter theorem STRONG!!!
— Angus “5 million shots a day" Grier (@ez_angus) March 26, 2021
The marketing and associated cultural capital, however, are indeed very different, and you can expect that to continue and possibly intensify.
Update: Biden will budge.
Friday assorted links
1. Are the UFOs foreign drones launched from submarines in the Atlantic? As always, please note that a link is not an endorsement.
2. How Swiss is your watch? (NYT)
3. Paul Graham on how people get rich now.
4. Germany stops recognizing special UK passport for HongKongers.
5. Republicans and big business (my Bloomberg column).
6. Will China send peacekeeping forces to Afghanistan to replace departing U.S. troops?
7. Turkey bans crypto payments.
8. Ryan Decker, et.al. estimate excess business deaths from the pandemic.
Mexican drug cartel now assassinates its enemies using drones?
Ho hum, nothing to see here:
Mexico’s drug cartels are notoriously well armed and equipped, with some possessing very heavy weaponry, including armored gun trucks sporting heavy machine guns. Now at least one of these groups appears to be increasingly making use of small quadcopter-type drones carrying small explosive devices to attack its enemies. This is just the latest example of a trend that has been growing worldwide in recent years, including among non-state actors, such as terrorists and criminals, which underscores the potential threats commercially-available unmanned systems pose on and off the battlefield.
Various police raids seem to have uncovered quadcopters armed with shrapnel. Just how speculative is this report? I do not know, but I have been expecting such developments for quite a few years now, and it would be sad if finally they were upon us. Here is the full story by Joseph Trevethick.
Green energy vs. green jobs
That is the theme of my latest Bloomberg column, here is the opening bit:
One of the most disturbing trends in recent economic thought is the view that green energy should be viewed as a source of good jobs. Such attitudes are bad for our polity and for our economy.
To be clear, the need for greener energy policies is imperative. Honest observers may disagree about the best paths forward, but a simple example illustrates the point about jobs.
Let’s say America’s energy supply was composed primarily of solar, wind, hydroelectric and nuclear power, mostly automated with a few workers for oversight and a dog to guard the factory gate.
The biggest obstacle to green energy is not that American voters love pollution and carbon emissions, but rather people do not wish to pay more for their gasoline and their home heating bills. If we insist that green energy create a lot of good jobs, in essence we are insisting that it have high labor costs, and thus we are producing a version of it that will meet consumer and also voter resistance.
That would be close to ideal, even if it involved fewer jobs on net than the current energy infrastructure. Ideally, we should be striving for an energy network that hardly provides any jobs at all. That would be a sign that we truly have produced affordable and indeed very cheap alternatives to energy produced by fossil fuels.
The issue of cost is all the more urgent because climate change is a global problem, not just a national one. We could make North America entirely green, but climate change would proceed apace, due to carbon emissions from other countries, most of all China and eventually India.
So what we need to produce are very cheap renewable technologies, ones so cheap that the poorer countries of the world will adopt them as well. If we insist on packing a lot of labor costs (“good jobs”) into our energy technologies, we will not come close to achieving that end.
And I suspect my colleague Don Boudreaux would remind us all of Bastiat’s excellent Candlemakers’ Petition to the Sun, relevant here in its very specifics.
I really have not seen Democratic economists pushing back against the Biden administration on this point. #thegreatforgetting
Thursday assorted links
1. Brian Arthur on verbal economics and what it is like.
2. A public choice theory of when the Chinese reopen cities under lockdown.
3. Scott Alexander on the new Honduran charter city, recommended.
4. Garett Jones on laissez-faire lockdowns plus liability law and tort — what exactly is the benchmark here for comparing to intervention?
5. GMO mosquitoes to be released in the Florida Keys.
6. Claims about Afghan troop withdrawal, from the excellent Tom Tugendhat.
My podcast with the excellent Nicholas Colin
Here goes, the topic was Europe only, mostly fresh material. Forty-four minutes. On Apple, and on Spotify.
“RCTs for me but not for thee”?
Zeke Emanuel, a professor of healthcare management at the University of Pennsylvania and a former coronavirus adviser to US president Joe Biden, said: “I understand they wanted to be transparent, but did they really have to announce a complete pause? “My concern is this will unnecessarily undermine confidence in the vaccine, and possibly all [Covid-19] vaccines. Are people going to know the difference?”
Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security in Baltimore, said: “The damage is done, this is going to be hard to resume. All [the CDC] can do is say how rare this is, show how safe and efficacious the J&J vaccine is. But this action is going to be hard to reverse.”
Here is the full FT piece. Since lives are at stake, how about this for a proposal? The FDA is allowed to suspend the use of any positive expected value vaccine only after running an RCT on their underlying theory of credibility and public risk communication in the relevant context. (NB: asking about attitude change is not nearly good enough!) And after they run the RCT, they have to wait three weeks to schedule the meeting on evaluating the data. After all, that is how long it takes, right?
Estamos de acuerdo?
By the way, one reader wrote to me: “I submit to you that the credibility of the FDA on the relative safety of various vaccines may be a minor issue in the pool of issues that prevent the level of vaccinations we would like to see.” Do we even know if that is true or false?
From the comments, on FDA credibility
Wednesday assorted links
1. Once again, the world is more right-wing than you think. Even Stanford academics. And these ants shrink their brains for a chance to become queen (NYT).
2. World’s longest rabbit theft moral hazard? (NYT): “Darius was insured for $1.6 million and traveled with a bodyguard, according to NBC’s Today show in a 2010 article.” Note that his status as the world’s longest rabbit already was under threat from his own descendants.
3. MIE: $4,000 Star Wars armchair (why?).
4. “Today in Markets in Everything, from the Netherlands: informal insurance for curfew violations via Whatsapp:
For a €10 prepaid fee, the owners of the Whatsapp group will wire you €95 (the fine for violating the curfew) after sending in a picture of the fine. It will also provide ‘safe’ routes through the city where policing is light.”
The Covid culture that is Australia
Health Minister Greg Hunt has refused to guarantee Australia’s borders will open even if the whole country has been vaccinated against COVID-19.
Australia’s borders have been shut since March 2020 and will remain closed until at least the middle of June, leaving more than 36,000 Australians trapped overseas, unable to return due to caps on the number of quarantine spaces.
The closure also bans citizens from leaving the country unless they have an exemption or are travelling to New Zealand.
Mr Hunt suggested at a news conference in Canberra on Tuesday the international border closures could last much longer and stay in place even if the entire population had been vaccinated against the coronavirus.
“Vaccination alone is no guarantee that you can open up,” Mr Hunt said.
“If the whole country were vaccinated, you couldn’t just open the borders.”
“We still have to look at a series of different factors: transmission, longevity [of vaccine protection] and the global impact – and those are factors which the world is learning about,” he said.
Really people? Via Chris.
“Free-floating credibility” is underrated
The presence of a minuscule risk for some of the adenovirus platform Covid vaccines means that the FDA has put a hold on J&J and still won’t approve AstraZeneca.
In response to critics, the FDA says that their credibility is on the line. If they allow vaccine use to proceed, and a modest number of people die as a result (with a big increase in net lives saved), the FDA and its defenders claim that people will lose faith in the FDA. Yet that is exactly the wrong thing to say, it is self-serving, and it exacerbates the problem at hand.
When the FDA announces that they have to ban a vaccine because its credibility is on the line, that very announcement puts their credibility on the line. It is a simple two-line proof. Either they are lying about whether their credibility is on the line, in which case they have wrecked their credibility with the lie. Or they are telling the truth, in which case by definition their credibility is indeed on the line.
One lesson is that you should not try to extend your credibility too far, because you will end up unduly constrained.
For purposes of contrast, consider alcoholic beverages. At the federal level they are regulated by the Alcohol and Tobacco Tax and Trade Bureau (who are they again?), and also various state and local authorities.
As a result of this unusual, Prohibition-rooted distribution of authority, alcohol does not come with nutritional labeling.
Now, in that setting, if a bunch of kids die from binge drinking, the credibility of the Bureau is not much damaged. The Bureau does not have to ban alcohol on the grounds that if it does not, the credibility of the Bureau will be ruined. The Bureau simply never put its credibility on the line in this manner.
Now you might favor a tighter regulation of alcohol for some reason, but you could achieve such regulation without tying up the credibility of the ATTT Bureau in knots. Similarly, the Department of Transportation regulates road safety (again with state and local authorities as well), but it has not put its credibility on the line when 40,000 or so Americans die each year on the roads. Again, maybe they should enforce tougher safety standards, but they shouldn’t tie their credibility to getting road deaths down to one hundred, and indeed they do not. They end up with more degrees of regulatory freedom.
Let’s say I were to announce that my credibility as a public intellectual were to depend at how I would fare at darts on British pub night. That would be a big mistake, for multiple reasons. It is like with the FDA. If I am lying about that credibility tie, I hurt my credibility as a public intellectual. If somehow I am telling the truth, well let’s just hope everyone else stays home that evening because my credibility is going to take a beating.
What I call “free-floating credibility” is underrated.
And that is precisely what defenders of the FDA destroy when they…defend the FDA. They make the FDA worse.
NB: You are “out of your lane” commenting on this analysis unless you have studied game theory with Thomas Schelling.
Vaccine fact of the day
Moderna and BioNTech shares jumped 10.5 per cent and 6.1 per cent, respectively, on Tuesday as the vaccine makers benefited from news of the J&J pause.
Norway’s health authorities estimated that their vaccination plans could be delayed by eight to 12 weeks if they could not use either the J&J or the Oxford/AstraZeneca vaccine.
The biggest short-term loser here is Europe, not the United States. Nor will this help Australia reopen. But does the American median voter or median FDA senior bureaucrat care? What will the CVS liability lawyers advise from here on out? What will the French anti-vaxxers think?
Here is the full FT article.
Tuesday assorted links
1. John Naisbett has passed away.
2. Suicides down for 2020, misery loves company?
3. What it is like to be in a human challenge trial. The argument that the muon results are for real.
4. Eric Weinstein on geometric unity. Is he right? Is that the right question?
5. “Dowbak utilizes the mechanics of the smart contract imbedded in the NFT to create a self-generating Genesis piece which will continue to create new, discreet NFTs over the course of approximately one year.” With sixty bids, the current value is well over $2 million, do take a look at the image. And it is stochastically not a Crusonia plant: “However, Dowbak has also introduced the element of chance into the work’s algorithm through another self-referential twist–REPLICATOR can also jam. A jam comes in the form of a unique “Jam Artwork,” which will stop a generation from continuing to replicate, curbing exponential growth.”
6. In Houston, autonomous cars are delivering Domino pizza.
7. DC’s rising libertarian star.
You may not agree with this, still it is a sign of how much progress green energy has made
Yes this is being asserted with a straight face and indeed it might be true!:
To reliably achieve deep decarbonization of the US power sector, a candidate policy must perform robustly across a range of possible future trajectories of demand, fossil fuel prices, and prices of new wind and solar capacity. Using a modified version of the NREL ReEDS model with scenarios that span different trajectories of demand, fuel prices, and technology costs, we find that some recently proposed policies can robustly achieve 80% decarbonization (relative to 2005 emissions) or more by 2035, but many do not. The two robustly successful policies are a tradeable performance standard (TPS) and a hybrid Clean Electricity Standard (CES) with a 100% clean target, partial crediting of gas generation, and a $40/mton CO2 alternative compliance payment (ACP) backstop. Both are nearly as cost effective as the emissions-equivalent efficient policy. A $40 carbon tax nearly achieves the robust 80% threshold and, in most scenarios, drives deep decarbonization. A 90% CES (without partial crediting) fails to achieve robust 2035 decarbonization because it need not drive coal out of the system. Simply extending renewable energy tax credits, which are set to expire, does not drive significant decarbonization in most scenarios, nor does relying on increased ambition in green-leaning states.
That is from a new NBER paper by James H. Stock and Daniel N. Stuart. The big problem remains global, of course, not to mention the political economy of these reforms, which are unlikely to be popular even in the Democratic Party and also would face massive regulatory hurdles at federalistic levels. Still, ten years ago I would not have expected to be at a point where such claims could be made by well-respected economists.
That is from Sure. So what is the best piece on FDA credibility? (Yes, I know the work of Daniel Carpenter and have a CWT with him coming out and we do address this directly.) And what has the FDA itself done to study the issue of its own credibility?